JP5388472B2 - A control device, an X-ray imaging system, a control method, and a program for causing a computer to execute the control method. - Google Patents

A control device, an X-ray imaging system, a control method, and a program for causing a computer to execute the control method. Download PDF

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JP5388472B2
JP5388472B2 JP2008104300A JP2008104300A JP5388472B2 JP 5388472 B2 JP5388472 B2 JP 5388472B2 JP 2008104300 A JP2008104300 A JP 2008104300A JP 2008104300 A JP2008104300 A JP 2008104300A JP 5388472 B2 JP5388472 B2 JP 5388472B2
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JP2009254428A (en
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裕之 漆家
修 辻井
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    • A—HUMAN NECESSITIES
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    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
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    • A61B6/504—Clinical applications involving diagnosis of blood vessels, e.g. by angiography
    • A—HUMAN NECESSITIES
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/40—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for generating radiation specially adapted for radiation diagnosis
    • A61B6/4021—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for generating radiation specially adapted for radiation diagnosis involving movement of the focal spot
    • A61B6/4028—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for generating radiation specially adapted for radiation diagnosis involving movement of the focal spot resulting in acquisition of views from substantially different positions, e.g. EBCT
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4417—Constructional features of apparatus for radiation diagnosis related to combined acquisition of different diagnostic modalities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4429—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units
    • A61B6/4435—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being coupled by a rigid structure
    • A61B6/4441—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit and the detector unit being coupled by a rigid structure the rigid structure being a C-arm or U-arm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/46—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with special arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/481—Diagnostic techniques involving the use of contrast agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/482—Diagnostic techniques involving multiple energy imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5217—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data extracting a diagnostic or physiological parameter from medical diagnostic data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/54—Control of apparatus or devices for radiation diagnosis
    • A61B6/547—Control of apparatus or devices for radiation diagnosis involving tracking of position of the device or parts of the device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/40—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for generating radiation specially adapted for radiation diagnosis
    • A61B6/405—Source units specially adapted to modify characteristics of the beam during the data acquisition process
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/42—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4291—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis the detector being combined with a grid or grating

Description

本発明は、Ｘ線動画撮影システムを用いてＤＳＡ（Digital Subtraction Angiography）撮影、或いはカテーテルや内視鏡を操作しながら透視撮影を行うためのＸ線動画撮影装置に関するものである。   The present invention relates to an X-ray moving image photographing apparatus for performing DSA (Digital Subtraction Angiography) photographing using an X-ray moving image photographing system or fluoroscopic photographing while operating a catheter or an endoscope.

近年、血管造影撮影においてＤＳＡ撮影の技術が普及している。ＤＳＡ撮影とは、先ず造影剤を注入する前にＸ線透視撮影を行うことにより、１枚のマスク画像を作成し、その後に、血管内に造影剤を注入してＸ線透視撮影を行い、マスク画像を減算することにより背景を消去する撮影方法である。これにより、造影剤が注入された血管のみの画像を表示することができる。   In recent years, DSA imaging technology has become widespread in angiography. DSA imaging first creates a mask image by performing X-ray fluoroscopy before injecting a contrast agent, and then injects a contrast agent into a blood vessel to perform X-ray fluoroscopy, In this method, the background is erased by subtracting the mask image. Thereby, the image of only the blood vessel into which the contrast agent is injected can be displayed.

このようなＤＳＡ撮影における重要な目的の１つに、血管の走行状態を把握できることがある。体内の血管は三次元空間に存在しているが、Ｘ線透視撮影によって三次元情報から二次元情報に圧縮されてしまうため、複雑な血管の走行状態を単純な二次元の画像から正確に把握することは極めて困難である。   One of the important purposes in such DSA imaging is to be able to grasp the running state of blood vessels. The blood vessels in the body exist in a three-dimensional space, but because X-ray fluoroscopy is compressed from three-dimensional information to two-dimensional information, it is possible to accurately grasp the running state of complex blood vessels from simple two-dimensional images. It is extremely difficult to do.

そこで、血管の走行状態を三次元的に把握するために、回転ＤＳＡ撮影の技術が開発されている。この回転ＤＳＡ撮影は例えばＣアームと呼ばれるアームの一端にＸ線源を取り付け、他端にイメージインテンシファイア又はフラットパネルディテクタから成るＸ線検出器が取り付けられた撮影装置を用いて撮影する。患者を中心にＣアームを回転させながらＸ線透視撮影を行い、回転角度毎のマスク画像を作成し、患者に造影剤を注入した後にマスク画像を作成した回転角度と同じ回転角度で撮影を行い、対応する回転角度のマスク画像を減算する。これにより、造影された血管のみの動画像を表示できる。   Therefore, in order to grasp the running state of the blood vessel three-dimensionally, a rotating DSA imaging technique has been developed. In this rotating DSA imaging, for example, imaging is performed using an imaging apparatus in which an X-ray source is attached to one end of an arm called a C arm and an X-ray detector comprising an image intensifier or a flat panel detector is attached to the other end. Perform fluoroscopic imaging while rotating the C-arm around the patient, create a mask image for each rotation angle, and perform imaging at the same rotation angle as the mask image was created after injecting contrast medium into the patient. Subtract the mask image of the corresponding rotation angle. Thereby, the moving image of only the contrasted blood vessel can be displayed.

また、血管造影撮影において造影剤を注入すると、造影剤はかなりの速度で広範囲に拡散するため、造影剤の流れを全て撮影するには、大きめのＸ線検出器を用いて、造影剤の流れる全ての範囲に渡って常にＸ線を曝射する必要がある。   In contrast, when contrast medium is injected in angiography, the contrast medium diffuses over a wide range at a considerable speed. Therefore, in order to capture the entire flow of contrast medium, a large X-ray detector is used to flow the contrast medium. It is necessary to always expose X-rays over the entire range.

カテーテルや内視鏡の操作における透視撮影においても、操作している部分だけではなく、広範囲に渡って常にＸ線を曝射して撮影を行う必要がある。   Even in fluoroscopic imaging in the operation of a catheter or endoscope, it is necessary to always perform imaging by exposing X-rays over a wide range, not only the operated part.

また、このような撮影方法とは別に、特許文献１においてＸ線の焦点位置を電子的にラスタ走査させるＸ線撮影装置の技術が開示されている。   In addition to such an imaging method, Patent Document 1 discloses a technique of an X-ray imaging apparatus that electronically scans an X-ray focal position.

特開平６−２１７９６４号公報JP-A-6-217964

しかし、回転ＤＳＡ撮影を行う場合においては、マスク画像の撮影と血管造影撮影の際に、それぞれＣアームを回転させて撮影を行わなければならない。このＣアームの回転は機械的な回転で操作者の負担は大きく、テーブルやその他の周囲のあらゆる物に衝突しないように注意する必要があり、撮影に集中することが困難である。   However, when performing rotational DSA imaging, imaging must be performed by rotating the C-arm at the time of imaging a mask image and angiographic imaging. The rotation of the C-arm is a mechanical rotation and places a heavy burden on the operator. Care must be taken not to collide with the table or any other surrounding objects, and it is difficult to concentrate on shooting.

また、血管造影撮影においては、造影剤注入後に造影剤の流れる全範囲に渡って、常にＸ線を曝射しているため、患者のＸ線被曝線量は極めて大きくなると共に、撮影を行う操作者のＸ線被曝も非常に大きなものとなってしまう。同様に、カテーテルや内視鏡の操作における透視撮影においても、患者及び操作者のＸ線被曝線量は非常に大きくなる。   In angiography, since the X-ray is always exposed over the entire range in which the contrast agent flows after the injection of the contrast agent, the X-ray exposure dose of the patient becomes extremely large and the operator who performs the imaging X-ray exposure will be very large. Similarly, the X-ray exposure dose of the patient and the operator is very large also in fluoroscopic imaging in the operation of the catheter and endoscope.

本発明の目的は、上述の問題点を解消し、機械的な動作を行うことなく、回転ＤＳＡ撮
影を実施できる装置を提供することにある。 An object of the present invention is to solve the above-described problems and provide an apparatus capable of performing rotational DSA imaging without performing a mechanical operation.

そこで本発明の実施形態に係る制御装置は、複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御装置であって、撮影対象に造影剤が流入していないタイミングと流入しているタイミングとのぞれぞれで、前記複数のＸ線焦点から順次選択されたＸ線焦点から前記被写体に対してＸ線を照射させる制御部と、造影剤が流入していないタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線をＸ線検出器で検出して得られる複数の第一のＸ線画像と、流入しているタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線を前記Ｘ線検出器で検出して得られる複数の第二のＸ線画像とを取得する取得手段と、前記Ｘ線焦点毎に前記第一のＸ線画像と前記第二のＸ線画像との差分画像を生成する生成手段と、を有することを特徴とする。 Therefore, a control apparatus according to an embodiment of the present invention is an X-ray imaging control apparatus that uses an X-ray source in which a plurality of X-ray focal points are arranged and an X-ray detector that detects an X-ray and obtains an image. And the X-ray focal point sequentially selected from the plurality of X-ray focal points at each of the timing at which the contrast medium does not flow into the imaging target and the timing at which the contrast agent flows into the subject. And a plurality of first X-rays obtained by detecting the irradiated X-rays from the sequentially selected X-ray focal points with an X-ray detector at a timing when no contrast agent flows in Acquisition means for acquiring an image and a plurality of second X-ray images obtained by detecting the irradiated X-rays from the sequentially selected X-ray focal points with the X-ray detector at the inflow timing And the first X-ray image and the second X-ray image for each X-ray focal point. And having a generating means for generating a difference image between.

本発明に係るＸ線画像撮影装置によれば、簡便な操作で高精度な回転ＤＳＡ画像が得ることができ、より的確な診断、手術が可能となる。 According to the X-ray imaging apparatus according to the present invention, a highly accurate rotating DSA image can be obtained by a simple operation, and more accurate diagnosis and surgery are possible.

また、血管造影撮影、カテーテル・内視鏡透視撮影においては、観察すべき部分の画質が向上し、カテーテル操作・内視鏡操作の精度が向上し、適確な診断、手術が可能となると共に、患者や操作者のＸ線被曝を減少することができる。   In angiography and catheter / endoscopic imaging, the image quality of the part to be observed is improved, the accuracy of catheter operation / endoscope operation is improved, and accurate diagnosis and surgery are possible. The X-ray exposure of patients and operators can be reduced.

本発明を図示の実施例に基づいて詳細に説明する。   The present invention will be described in detail based on the embodiments shown in the drawings.

図１はＸ線動画撮影システムの一例の構成図である。Ｘ線を発生するＸ線源１と、このＸ線源１から発生したＸ線を検出するＸ線検出器２が対向して配置され、Ｘ線源１とＸ線検出器２との間には、被検者Ｓを載置するテーブル３が配置されている。なお、後述するように、Ｘ線源１には鉛絞り１ａ、Ｘ線検出器２にはグリッド２ａが付設されている。   FIG. 1 is a configuration diagram of an example of an X-ray moving image photographing system. An X-ray source 1 that generates X-rays and an X-ray detector 2 that detects X-rays generated from the X-ray source 1 are arranged to face each other, and between the X-ray source 1 and the X-ray detector 2. The table 3 on which the subject S is placed is arranged. As will be described later, a lead diaphragm 1a is attached to the X-ray source 1, and a grid 2a is attached to the X-ray detector 2.

Ｘ線源１には、Ｘ線の発生を制御するＸ線発生装置制御部４を介してＸ線撮影システム制御部５の出力が接続されている。また、Ｘ線検出器２の出力は画像入力部６を介してＸ線撮影システム制御部５に接続されている。Ｘ線撮影システム制御部５には、機構を制御する機構制御部７、画像処理を行う画像処理部８、画像を保存する画像保存部９、画像を表示する診断モニタ１０、各種の操作を行う操作部１１が接続されている。また、このＸ線撮影システム制御部５にはネットワーク１２を介して、外部のプリンタ１３、診断ワークステーション１４、画像データベース１５が接続されている。   The X-ray source 1 is connected to an output of an X-ray imaging system control unit 5 via an X-ray generator control unit 4 that controls generation of X-rays. The output of the X-ray detector 2 is connected to the X-ray imaging system control unit 5 via the image input unit 6. The X-ray imaging system control unit 5 performs a mechanism control unit 7 that controls the mechanism, an image processing unit 8 that performs image processing, an image storage unit 9 that stores images, a diagnostic monitor 10 that displays images, and various operations. An operation unit 11 is connected. Further, an external printer 13, a diagnostic workstation 14, and an image database 15 are connected to the X-ray imaging system control unit 5 via a network 12.

Ｘ線発生装置制御部４により制御されたＸ線源１から発生したＸ線は、被写体Ｓを透過して被写体像としてＸ線検出器２により検出され、この検出されたＸ線像は画像データとして画像入力部６を介してＸ線撮影システム制御部５に入力される。画像データは画像処理部８においてＸ線検出器２の補正、ログ変換を含めた前処理やノイズ除去や鮮鋭化、ダイナミックレンジ圧縮のような高画質化処理や、画像解析処理等の画像処理が施される。   X-rays generated from the X-ray source 1 controlled by the X-ray generator control unit 4 pass through the subject S and are detected as a subject image by the X-ray detector 2, and the detected X-ray image is image data. Is input to the X-ray imaging system control unit 5 via the image input unit 6. The image data is subjected to image processing such as preprocessing including correction of the X-ray detector 2, log conversion, noise removal, sharpening, dynamic range compression, and image analysis processing in the image processing unit 8. Applied.

そして、これらの画像処理が施された画像は診断モニタ１０に表示され、動画撮影はこれを連続的に繰り返すことによって、時系列画像を得て連続表示される。また、このようにして得られた時系列画像は、画像保存部９に保存されたり、ネットワーク１２を介してプリンタ１３、診断ワークステーション１４、画像データベース１５に出力される。   The images subjected to these image processes are displayed on the diagnostic monitor 10, and the moving image shooting is continuously repeated to obtain time-series images and continuously display them. The time-series images obtained in this way are stored in the image storage unit 9 or output to the printer 13, diagnostic workstation 14, and image database 15 via the network 12.

図２はＸ線源１とＸ線検出器２を保持する保持機構であるＣアームの構成図を示している。Ｃアーム２１の両端にはＸ線源１とＸ線検出器２がそれぞれ固定され、このＣアーム２１は矢印Ａ〜Ｃに示すＸ軸、Ｙ軸、Ｚ軸の３方向に回転できるようになっている。また、テーブル３もＣアーム２１と連動しながら矢印Ｄ〜Ｆに示す前後、左右、上下の３方向の移動が可能である。   FIG. 2 shows a configuration diagram of the C arm which is a holding mechanism for holding the X-ray source 1 and the X-ray detector 2. The X-ray source 1 and the X-ray detector 2 are fixed to both ends of the C-arm 21, respectively. The C-arm 21 can rotate in three directions indicated by arrows A to C, ie, the X-axis, Y-axis, and Z-axis. ing. The table 3 can also be moved in the three directions of front and rear, left and right, and up and down as indicated by arrows D to F while interlocking with the C arm 21.

このテーブル３及びＣアーム２１は、図示を省略しているが機構制御部７により制御され、被検者Ｓの任意の方向、任意の位置の画像を得ることができる。   Although not shown, the table 3 and the C arm 21 are controlled by the mechanism control unit 7 and can obtain an image of an arbitrary direction and an arbitrary position of the subject S.

このようなＸ線動画撮影システムを用いて、回転ＤＳＡ撮影やカテーテル・内視鏡操作の透視撮影が行われる。回転ＤＳＡ撮影においては、先ず造影剤を注入する前に、マスク画像の撮影を行う。この際に、従来ではＣアーム２１を図２に示すＡ方向又はＢ方向に回転させながら撮影を行っていた。しかし、本実施例においては最初にＣアームを動かしてポジショニングをしてしまえば、撮影中はＣアーム２１を駆動することなく、図３（ａ）に示すように、造影剤が流れると思われる範囲で或る一定の方向にＸ線焦点位置を走査する。図３（ｂ）はこれを患者Ｓの頭方向から見た断面図である。   Using such an X-ray moving image photographing system, rotational DSA photographing and fluoroscopic photographing of a catheter / endoscope operation are performed. In rotating DSA imaging, first, before injecting a contrast agent, imaging of a mask image is performed. At this time, conventionally, photographing was performed while rotating the C-arm 21 in the A direction or the B direction shown in FIG. However, in this embodiment, if the C-arm is first moved and positioned, the contrast agent will flow as shown in FIG. 3A without driving the C-arm 21 during imaging. The X-ray focal position is scanned in a certain direction within the range. FIG. 3B is a cross-sectional view of the patient S viewed from the head direction.

Ｘ線源１では鉛絞り１ａにより区画されて平面上にＮ×ＭのＸ線焦点が配置されている。このＸ線焦点を上述の方向に選択的に走査することによって、Ｃアーム２１を駆動してＸ線照射したと同様のＸ線照射を実現することができる。このようにＸ線焦点位置を走査しながら、グリッド２ａを有するＸ線検出器２を用いて撮影を行うことにより、Ｘ線焦点位置毎の画像を得ることができ、これをマスク画像とする。   In the X-ray source 1, an N × M X-ray focal point is arranged on a plane divided by a lead diaphragm 1 a. By selectively scanning the X-ray focal point in the above-described direction, the same X-ray irradiation as when the C-arm 21 is driven and X-ray irradiation is performed can be realized. By performing imaging using the X-ray detector 2 having the grid 2a while scanning the X-ray focal position in this way, an image for each X-ray focal position can be obtained, and this is used as a mask image.

マスク画像を撮影した後に、患者Ｓの血管Ｖに造影剤Ｍを注入する。造影剤Ｍが血管Ｖに行き渡ると、マスク画像作成時と同じ方法によりＸ線焦点位置を走査して撮影を行う。この際に、画像毎に同じＸ線焦点位置で撮影した先のマスク画像を一致させ、マスク画像を減算することにより余分な背景が消去されて、造影された血管Ｖのみの動画画像を得ることができる。しかも、Ｘ線焦点位置が変化しているため、Ｘ線焦点位置の走査に従って、減算画像を連続的に表示することにより、種々のＸ線入射角度から造影された血管Ｖを観察することができる。これにより、複雑な血管Ｖの走行状態や血管瘤、狭窄等を三次元的に正確に把握することが可能となる。   After taking the mask image, the contrast medium M is injected into the blood vessel V of the patient S. When the contrast medium M reaches the blood vessel V, the X-ray focal position is scanned by the same method as that for creating the mask image. At this time, the previous mask image taken at the same X-ray focal position for each image is matched, and the mask image is subtracted to erase the excess background, thereby obtaining a moving image of only the contrasted blood vessel V. Can do. Moreover, since the X-ray focal position changes, the blood vessels V contrasted from various X-ray incident angles can be observed by continuously displaying the subtracted images according to the scanning of the X-ray focal position. . As a result, it is possible to accurately grasp the running state of the complex blood vessel V, an aneurysm, stenosis, and the like three-dimensionally.

実施例２においては、カテーテルや内視鏡を操作しながら透視撮影を行う。図４（ａ）はカテーテル操作時における説明図であり、先ずカテーテル３１を患者Ｓの血管Ｖ内に挿入し目的位置Ｐまで到達させる。このとき、Ｘ線焦点位置はカテーテル３１の先端を追跡して移動するように選択する。図４（ｂ）に示すように、Ｘ線源１とＸ線検出器２を対向して配置し、Ｘ線源１の各焦点位置の座標を（ｘ、ｙ）、Ｘ線検出器２の各画素の位置の座標を（Ｘ、Ｙ）として、座標（Ｘ、Ｙ）と空間的に最も近い座標（ｘ、ｙ）の対応関係をテーブル化しておく。   In Example 2, fluoroscopic imaging is performed while operating a catheter or an endoscope. FIG. 4A is an explanatory diagram when operating the catheter. First, the catheter 31 is inserted into the blood vessel V of the patient S to reach the target position P. FIG. At this time, the X-ray focal position is selected so as to move following the tip of the catheter 31. As shown in FIG. 4B, the X-ray source 1 and the X-ray detector 2 are arranged to face each other, the coordinates of the focal positions of the X-ray source 1 are (x, y), and the X-ray detector 2 With the coordinates of the position of each pixel as (X, Y), the correspondence between the coordinates (X, Y) and the spatially closest coordinates (x, y) is tabulated.

そして、Ｘ線透視画像からカテーテル３１の先端の位置を決定する。これには時系列の各画像について１つ前の画像を減算することにより、動きがあった部分を抽出してその座標を求めれば、カテーテル３１の先端の位置を決定することができる。   Then, the position of the distal end of the catheter 31 is determined from the X-ray fluoroscopic image. For this purpose, the position of the distal end of the catheter 31 can be determined by subtracting the previous image from each time-series image and extracting the portion where the motion has occurred to obtain the coordinates thereof.

カテーテル３１の先端位置の座標が決定すると、この座標はＸ線検出器２における位置座標であるから、上述のテーブル化した対応関係によりカテーテル３１の先端の位置に対応するＸ線源１のＸ線焦点位置の座標を求めることができる。そして、このＸ線焦点位置を選択してＸ線を曝射することより、カテーテル３１の先端を追跡してＸ線を照射することができる。   When the coordinates of the distal end position of the catheter 31 are determined, the coordinates are the position coordinates in the X-ray detector 2, and therefore the X-ray of the X-ray source 1 corresponding to the position of the distal end of the catheter 31 according to the table-like correspondence described above. The coordinates of the focal position can be obtained. Then, by selecting the X-ray focal position and exposing the X-ray, the tip of the catheter 31 can be tracked and the X-ray can be irradiated.

そして、カテーテル３１が目的の位置に到達したところで、カテーテル３１の他端から造影剤Ｍを注入する。注入された造影剤Ｍはその先の血管Ｖに拡散してゆくが、それは１本の血管Ｖではなく、多岐に渡った血管Ｖに拡散してゆく。このときには、拡散してゆく血管全体の重心位置に対応するＸ線焦点位置からＸ線を照射する。血管Ｖ全体の重心位置はカテーテル３１の先端のときと同様に、時系列画像において１つ前の画像を減算するが、この差分がここでは様々な位置に分散して存在することになる。そこで、この分散した位置の重心を求め、この位置をＸ線焦点位置とする。   Then, when the catheter 31 reaches the target position, the contrast medium M is injected from the other end of the catheter 31. The injected contrast medium M diffuses into the blood vessel V ahead, but it diffuses not into one blood vessel V but into various blood vessels V. At this time, X-rays are emitted from the X-ray focal point position corresponding to the center of gravity position of the entire blood vessel that is diffusing. As in the case of the distal end of the catheter 31, the center of gravity of the entire blood vessel V is subtracted from the previous image in the time-series image, but this difference is present in various positions. Therefore, the center of gravity of the dispersed positions is obtained, and this position is set as the X-ray focal position.

このように、Ｘ線焦点位置を順次に決めてＸ線照射を行うことにより、拡散してゆく造影剤Ｍに追随した動画によるＸ線透視画像が得られる。カテーテル３１の挿入後、或いは造影剤Ｍの注入後に選択された注目点であるＸ線焦点位置は、その後も常に順次に選択するようにすれば、挿入されたカテーテル３１全体と造影された血管Ｖ全体にＸ線を照射することができる。   In this way, by sequentially determining the X-ray focal position and performing X-ray irradiation, an X-ray fluoroscopic image by a moving image following the contrast medium M that is diffusing can be obtained. If the X-ray focal position, which is the point of interest selected after insertion of the catheter 31 or after injection of the contrast medium M, is always selected sequentially thereafter, the entire inserted catheter 31 and the contrasted blood vessel V The whole can be irradiated with X-rays.

図５は実施例３における内視鏡操作時における説明図である。内視鏡３２を操作する場合も実施例２のカテーテル３１の操作と同様に、内視鏡３２の先端を追跡してＸ線焦点位置を変化させて照射する。   FIG. 5 is an explanatory diagram when the endoscope is operated in the third embodiment. When the endoscope 32 is operated, similarly to the operation of the catheter 31 of the second embodiment, the tip of the endoscope 32 is tracked and the X-ray focal position is changed and irradiated.

この実施例３においては、Ｘ線動画像の撮影は上述の実施例１、２の説明に加えて、エネルギサブトラクションの技術を用いている。エネルギサブトラクションとは、管電圧を変化させることにより、照射するＸ線のエネルギを変化させて２回照射し、その差分をとって画像化するものである。これはエネルギの違いによるＸ線吸収率の差が物質によって変化することを利用したものであり、通常の１回のＸ線照射のみの画像とは違った画像を得ることができる。   In the third embodiment, the X-ray moving image is captured using the energy subtraction technique in addition to the description of the first and second embodiments. In the energy subtraction, the X-ray energy to be irradiated is changed twice by changing the tube voltage, and the difference is imaged. This utilizes the fact that the difference in the X-ray absorption rate due to the difference in energy varies depending on the substance, and an image different from a normal image of only one X-ray irradiation can be obtained.

そこで、上述した方法で１回のＸ線照射をエネルギを切換えて２回照射して差分を求めることによって、エネルギサブトラクション透視撮影における実施が可能である。   Therefore, the energy subtraction fluoroscopic imaging can be carried out by obtaining the difference by irradiating twice by switching the energy of one X-ray irradiation by the method described above.

この実施例３では、患者Ｓの体内に内視鏡３２が挿入されるので、図６に示すように、Ｘ線動画像と並べて内視鏡動画像を診断モニタ１０に表示することにより、体の位置と内部の位置関係を把握することができ、効果的である。   In the third embodiment, since the endoscope 32 is inserted into the body of the patient S, the endoscope moving image is displayed on the diagnostic monitor 10 along with the X-ray moving image, as shown in FIG. It is effective because it is possible to grasp the positional relationship between and the internal position.

Ｘ線動画撮影システムの構成図である。1 is a configuration diagram of an X-ray moving image capturing system. Ｃアームの構成図である。It is a block diagram of C arm. 血管造影撮影の説明図である。It is explanatory drawing of angiography imaging | photography. カテーテル撮影の説明図である。It is explanatory drawing of catheter imaging | photography. 内視鏡撮影の説明図である。It is explanatory drawing of endoscopic imaging | photography. 診断モニタ画面の説明図である。It is explanatory drawing of a diagnostic monitor screen.

符号の説明Explanation of symbols

１ Ｘ線源
１ａ 鉛絞り
２ Ｘ線検出器
２ａ グリッド
３ テーブル
４ Ｘ線発生装置制御部
５ Ｘ線撮影システム制御部
６ 画像入力部
７ 機構制御部
８ 画像処理部
９ 画像保存部
１０ 診断モニタ
１１ 操作部
１２ ネットワーク
１３ プリンタ
１４ 診断ワークステーション
１５ 画像データベース
２１ Ｃアーム
３１ カテーテル
３２ 内視鏡
Ｓ 患者
Ｖ 血管
Ｍ 造影剤 DESCRIPTION OF SYMBOLS 1 X-ray source 1a Lead stop 2 X-ray detector 2a Grid 3 Table 4 X-ray generator control part 5 X-ray imaging system control part 6 Image input part 7 Mechanism control part 8 Image processing part 9 Image storage part 10 Diagnostic monitor 11 Operation unit 12 Network 13 Printer 14 Diagnostic workstation 15 Image database 21 C-arm 31 Catheter 32 Endoscope S Patient V Blood vessel M Contrast agent

Claims (17)

複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御装置であって、
撮影対象に造影剤が流入していないタイミングと流入しているタイミングとのぞれぞれで、前記複数のＸ線焦点から順次選択されたＸ線焦点からＸ線を照射させる制御部と、
造影剤が流入していないタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線をＸ線検出器で検出して得られる複数の第一のＸ線画像と、流入しているタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線を前記Ｘ線検出器で検出して得られる複数の第二のＸ線画像とを取得する取得手段と、
前記Ｘ線焦点毎に前記第一のＸ線画像と前記第二のＸ線画像との差分画像を生成する生成手段と、
を有することを特徴とするＸ線撮影の制御装置。 A control device for X-ray imaging using an X-ray source in which a plurality of X-ray focal points are arranged and an X-ray detector that detects an X-ray and obtains an image,
A control unit that irradiates X-rays from X-ray focal points sequentially selected from the plurality of X-ray focal points at a timing when the contrast medium does not flow into the imaging target and a timing when the imaging agent flows in ;
A plurality of first X-ray image obtained by detecting the X-rays the radiation from the X-ray focal point said sequentially selected at a timing when the contrast medium is not flowing in the X-ray detector, inlet to which the timing an acquisition unit configured to acquire a plurality of second X-ray images obtained by the irradiated X-rays from the X-ray focal point said sequentially selected is detected by the X-ray detector in,
Generating means for generating a difference image between the first X-ray image and the second X-ray image for each X-ray focal point;
A control apparatus for X-ray imaging characterized by comprising: 複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御装置であって、
Ｘ線検出器によって取得されたＸ線画像の変化に基づいて血管中において造影剤の流入する複数の先端位置を決定する決定手段と、
造影剤の流入する先端位置とＸ線焦点との対応関係を示す情報と、前記複数の先端位置の重心位置とに基づいて、少なくとも１つのＸ線焦点を前記複数のＸ線焦点から選択する選択手段と、
当該選択されたＸ線焦点から前記被写体に対してＸ線を照射させる制御部と、
を有することを特徴とする制御装置。 A control device for X-ray imaging using an X-ray source in which a plurality of X-ray focal points are arranged and an X-ray detector that detects an X-ray and obtains an image,
Determining means for determining a plurality of tip positions into which a contrast agent flows in a blood vessel based on a change in an X-ray image acquired by an X-ray detector;
Selection for selecting at least one X-ray focus from the plurality of X-ray focal points based on information indicating the correspondence between the tip position into which the contrast agent flows and the X-ray focal points and the gravity center positions of the plurality of tip positions Means,
A controller that irradiates the subject with X-rays from the selected X-ray focal point;
A control device comprising: 前記決定手段は、前記Ｘ線検出器によって得られるＸ線動画像の第一のフレームと該第一のフレームに先立つ第二のフレームとの差分に基づいて造影剤の流入する先端位置を決定する
ことを特徴とする請求項２に記載の制御装置。 The determining means determines a tip position into which a contrast medium flows based on a difference between a first frame of an X-ray moving image obtained by the X-ray detector and a second frame preceding the first frame. The control device according to claim 2. 前記Ｘ線画像のそれぞれは、エネルギサブトラクションにより得られた差分画像であることを特徴とする請求項１または２に記載の制御装置。   The control device according to claim 1, wherein each of the X-ray images is a difference image obtained by energy subtraction. 前記選択手段は、前記被写体に対する造影剤の注入がなされた後に、前記造影剤の先端位置及び重心位置のいずれかに応じて前記Ｘ線焦点の照射角度が変更されるように、前記Ｘ線焦点を変更することを特徴とする請求項２に記載の制御装置。 The X-ray focal point is arranged so that the selection unit changes the irradiation angle of the X-ray focal point according to either the tip position or the center of gravity position of the contrast agent after the contrast agent is injected into the subject. The control device according to claim 2, wherein the control device is changed. 前記Ｘ線画像は動画像であり、
前記決定手段は、前記Ｘ線画像のフレーム間差分に基づいて前記造影剤の先端位置及び重心位置のいずれかを決定する
ことを特徴とする請求項２に記載の制御装置。 The X-ray image is a moving image,
The control device according to claim 2, wherein the determining unit determines one of a tip position and a gravity center position of the contrast agent based on an inter-frame difference of the X-ray image. 前記対応関係を示す情報を記憶する記憶部を更に有し、
前記決定手段は、前記対応関係を示す情報を用いて前記Ｘ線画像に基づき前記Ｘ線焦点の位置を決定する
ことを特徴とする請求項２乃至６のいずれか１項に記載の制御装置。 A storage unit that stores information indicating the correspondence ;
The control device according to claim 2, wherein the determination unit determines the position of the X-ray focal point based on the X-ray image using information indicating the correspondence relationship . 被写体内に挿入された内視鏡で撮影された内視鏡画像を取得する内視鏡画像取得手段と、
前記制御に応じて発生されたＸ線をＸ線検出器で検出して前記被写体内の内視鏡を撮影したＸ線画像を取得するＸ線画像取得手段と、
前記Ｘ線画像における前記内視鏡の位置を前記Ｘ線画像に基づいて決定する決定手段と、
前記決定された内視鏡の位置に基づいて前記内視鏡をＸ線撮影するようにＸ線源を制御しＸ線を発生させる制御手段と、前記内視鏡画像と前記Ｘ線画像とを並べて表示部に表示させる表示制御手段と、を有することを特徴とする制御装置。 Endoscopic image acquisition means for acquiring an endoscopic image photographed by an endoscope inserted into a subject;
X-ray image acquisition means for detecting an X-ray generated in accordance with the control with an X-ray detector and acquiring an X-ray image obtained by photographing an endoscope in the subject;
Determining means for determining a position of the endoscope in the X-ray image based on the X-ray image;
Control means for generating an X-ray by controlling an X-ray source so as to X-ray the endoscope based on the determined position of the endoscope, and the endoscope image and the X-ray image. And a display control means for displaying them side by side on the display unit. 前記制御装置は、複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御装置であり、
前記制御手段は、内視鏡の位置とＸ線焦点との対応関係を示す情報と、前記内視鏡の位置とに基づいてＸ線焦点を前記Ｘ線源の複数のＸ線焦点から選択することを特徴とする請求項８に記載の制御装置。 The control device is an X-ray imaging control device using an X-ray source in which a plurality of X-ray focal points are arranged and an X-ray detector that detects an X-ray and obtains an image,
The control means selects an X-ray focal point from a plurality of X-ray focal points of the X-ray source based on information indicating a correspondence relationship between the position of the endoscope and the X-ray focal point and the position of the endoscope. The control device according to claim 8. 請求項１乃至９のいずれか１項に記載の制御装置と、
前記複数のＸ線焦点を有するＸ線源と、
を有することを特徴とするＸ線撮影システム。 A control device according to any one of claims 1 to 9,
An X-ray source having the plurality of X-ray focal points;
An X-ray imaging system comprising: 請求項１乃至９のいずれか１項に記載の制御装置と、
前記Ｘ線検出器と、
を有することを特徴とするＸ線撮影システム。 A control device according to any one of claims 1 to 9,
The X-ray detector;
An X-ray imaging system comprising: 請求項８または９に記載の制御装置と、
前記内視鏡と、
を有することを特徴とする撮影システム。 A control device according to claim 8 or 9,
The endoscope;
An imaging system comprising: 複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御方法であって、
撮影対象に造影剤が流入していないタイミングと流入しているタイミングとのぞれぞれで、前記複数のＸ線焦点から順次選択されたＸ線焦点からＸ線を照射させるステップと、
造影剤が流入していないタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線をＸ線検出器で検出して得られる複数の第一のＸ線画像と、造影剤が流入しているタイミングで前記順次選択されたＸ線焦点から前記照射されたＸ線を前記Ｘ線検出器で検出して得られる複数の第二のＸ線画像とを取得するステップと、
前記Ｘ線焦点毎に前記第一のＸ線画像と前記第二のＸ線画像との差分画像を生成するステップと、
を有することを特徴とするＸ線撮影の制御方法。 A control method of X-ray imaging using an X-ray source in which a plurality of X-ray focal points are arranged side by side and an X-ray detector that detects an X-ray and obtains an image,
Irradiating an X-ray from an X-ray focal point sequentially selected from the plurality of X-ray focal points at each of a timing when a contrast agent does not flow into the imaging target and a timing when the contrast agent flows in ;
A plurality of first X-ray images obtained by detecting the irradiated X-rays from the sequentially selected X-ray focal points with an X-ray detector at a timing when no contrast agent flows , and a contrast agent flows acquiring a plurality of second X-ray image obtained has an X-ray of the is the irradiation from sequentially selected X-ray focal point at the timing detected by the X-ray detector,
Generating a difference image between the first X-ray image and the second X-ray image for each X-ray focal point;
A control method for X-ray imaging, comprising: 複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御方法であって、
Ｘ線検出器によって取得されたＸ線画像の変化に基づいて血管中において造影剤の流入する複数の先端位置を決定するステップと、
造影剤の流入する先端位置とＸ線焦点との対応関係を示す情報と、前記複数の先端位置の重心位置とに基づいて、少なくとも１つのＸ線焦点を前記複数のＸ線焦点から選択するステップと、
制御部が、当該選択されたＸ線焦点からＸ線を照射させるステップと、を有することを特徴とするＸ線撮影の制御方法。 A control method of X-ray imaging using an X-ray source in which a plurality of X-ray focal points are arranged side by side and an X-ray detector that detects an X-ray and obtains an image,
Determining a plurality of tip positions into which a contrast agent flows in a blood vessel based on a change in an X-ray image acquired by an X-ray detector;
Selecting at least one X-ray focus from the plurality of X-ray focal points based on information indicating a correspondence relationship between the tip position into which the contrast agent flows and the X-ray focal points and the gravity center positions of the plurality of tip positions. When,
And a step of irradiating X-rays from the selected X-ray focal point. 撮影対象の内部に挿入された内視鏡で撮影された内視鏡画像を取得するステップと、
Ｘ線源から発生されたＸ線をＸ線検出器で検出して前記挿入された内視鏡を撮影したＸ線画像を取得するステップと、
前記Ｘ線画像における前記内視鏡の位置を前記Ｘ線画像に基づいて決定するステップと、
前記決定された内視鏡の位置に基づいて前記内視鏡をＸ線撮影するようにＸ線源を制御しＸ線を発生させるステップと、
前記内視鏡画像と前記Ｘ線画像とを並べて表示部に表示させるステップと、
を有することを特徴とする制御方法。 Obtaining an endoscopic image photographed with an endoscope inserted inside the photographing object ;
Detecting an X-ray generated from an X-ray source with an X-ray detector and acquiring an X-ray image of the inserted endoscope; and
Determining the position of the endoscope in the X-ray image based on the X-ray image;
Generating an X-ray by controlling an X-ray source to X-ray the endoscope based on the determined position of the endoscope ;
Displaying the endoscopic image and the X-ray image side by side on a display unit;
A control method characterized by comprising: 前記制御方法は、複数のＸ線焦点が並べて配置されたＸ線源と、Ｘ線を検出して画像を得るＸ線検出器とを用いたＸ線撮影の制御方法であり、
前記Ｘ線を発生させるステップでは、内視鏡の位置とＸ線焦点との対応関係を示す情報と、前記内視鏡の位置とに基づいてＸ線焦点を前記Ｘ線源の複数のＸ線焦点から選択することを特徴とする請求項１５に記載の制御方法。 The control method is a control method of X-ray imaging using an X-ray source in which a plurality of X-ray focal points are arranged and an X-ray detector that detects an X-ray and obtains an image,
In the step of generating the X-ray, the X-ray focus is changed to a plurality of X-rays of the X-ray source based on information indicating a correspondence relationship between the position of the endoscope and the X-ray focus and the position of the endoscope. The control method according to claim 15, wherein the control method is selected from a focal point. 請求項１３乃至１６のいずれか１項に記載の制御方法をコンピュータに実行させるためのプログラム。   A program for causing a computer to execute the control method according to any one of claims 13 to 16.
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